A Graphene Composite Film Based Wearable Far‐Infrared Therapy Apparatus (GRAFT) for Effective Prevention of Postoperative Peritoneal Adhesion

Abstract

AbstractPostoperative peritoneal adhesion (PPA) is the most frequent complication after abdominal surgery. Current anti‐adhesion strategies largely rely on the use of physical separating barriers creating an interface blocking peritoneal adhesion, which cannot reduce inflammation and suffers from limited anti‐adhesion efficacy with unwanted side effects. Here, by exploiting the alternative activated macrophages to alleviate inflammation in adhesion development, a flexible graphene‐composite‐film (F‐GCF) generating far‐infrared (FIR) irradiation that effectively modulates the macrophage phenotype toward the anti‐inflammatory M2 type, resulting in reduced PPA formation, is designed. The anti‐adhesion effect of the FIR generated by F‐GCF is determined in the rat abdominal wall abrasion‐cecum defect models, which exhibit reduced incidence and area of PPA by 67.0% and 92.1% after FIR treatment without skin damage, significantly superior to the clinically used chitosan hydrogel. Notably, within peritoneal macrophages, FIR reduces inflammation reaction and promotes tissue plasminogen activator (t‐PA) level via the polarization of peritoneal macrophages through upregulating Nr4a2 expression. To facilitate clinical use, a wirelessly controlled, wearable, F‐GCF‐based FIR therapy apparatus (GRAFT) is further developed and its remarkable anti‐adhesion ability in the porcine PPA model is revealed. Collectively, the physical, biochemical, and in vivo preclinical data provide compelling evidence demonstrating the clinical‐translational value of FIR in PPA prevention.